Community grant application form

Eligibility

To be eligible for consideration, non-profit, sporting and recreation, and community organisation applicants must:

Work within or provide services to communities within Roy Hill’s operational footprint; Town of Port Hedland, Shire of East Pilbara or Shire of Ashburton.
Be incorporated or auspiced via another incorporated body.
Individuals, sole traders and companies are not eligible to apply for funding.

Roy Hill will not consider funding:

Any contact sport league or high risk activity.
Team uniforms and/or travel for sporting teams, clubs and organisations (Note: Hancock Prospecting do provide this support for specific elite sporting teams, separate to this community-level Program).
Individual pursuits, including sporting activities and academic studies.
Religious activities or political organisations or purposes.
Activities or events that have already occurred.
Activities that involve gambling.

Please select your organisation type(Required)

Incorporated organisation

Auspiced organisation

Organisation details

What is the name and address of your organisation?

Organisation name:(Required)

Address:(Required)

Street Address Address Line 2 City State Post Code

Contact person for your organisation:

Contact name:(Required)

Position:(Required)

Phone number:(Required)

Email:(Required)

Is your organisation registered for GST?(Required)

Yes

No

Is your organisation incorporated?(Required)

Yes

No

If yes, what is your organisation ABN?(Required)

Auspice organisation

If you are not an incorporated organisation you will require an auspice to facilitate the funding on your behalf.

Details of the incorporated organisation that will auspice you:

Organisation name:(Required)

Contact name:(Required)

Phone number:(Required)

Email:(Required)

ABN:(Required)

Is your auspice registered for GST?(Required)

Yes

No

Funding details

Please enter all sources of income for the project including:

Amount of money your organisation or group is contributing towards the project (this may be through fundraising, etc)
Amount of money your organisation or group has secured from others, for this project (please provide their details); and
Amount of money your organisation or group is seeking from the Roy Hill Committee.

Funding

Breakdown your organisation’s contribution and funding secured from others:

Funding	Amount exc GST	Actions

There are no Funds.

Total income exc GST

Price: $ 0.00

Expenses

Expenses	Amount exc GST	Actions

There are no Expenses.

Total expenses exc GST

Price: $ 0.00

Funding request(Required)

Total amount of funding requested from Roy Hill (maximum $10,000)?

Community grant application form

Building Better Communities.

Eligibility

Organisation details

Auspice organisation

Previous funding

Project details

Funding details

Acknowledgment of support

Declaration